Sara Lambert

Psychiatry Coordinator at Urgent Crisis Center Child and Family Agency of Southeastern Connecticut, Inc.

Links: https://www.childandfamilyagency.org/programs/urgent-crisis-center/

Interview

Can you share some details about yourself, background, education and relevant training you've received?

I began college at UConn but transferred multiple times due to personal preferences and life changes. I moved around some before landing in Alaska where I completed a bachelor’s degree in social work. I started my professional career in social work at a child advocacy center, Alaska CARES, serving children who experienced abuse by providing case management (connecting families to appropriate services), performing forensic interviews, collaborating with legal entities (local/state police, FBI, military PD), and testifying in court. Worked with uninsured/underinsured children with their DCF unit whom needing trauma therapies Attachment Regulation Competency and Trauma Focused Cognitive Behavioral Therapy (ARC and TFCBT). While working at Alaska CARES, I started an accelerated Master of Social Work program with the clinical practicum work on a [psychiatric] subacute floor working with adolescents and adults. Then moved to Wisconsin and began working for CPS as an ongoing case manager and participated in a grant looking at how providing CPS workers with trauma informed care training impacted outcomes for families; this granted afforded consultation with Dr. Bruce Perry and trainings co-designed by Dr. Anda (co-author of ACE study). Following a big life change, I moved back home to CT and pursued an MSN through Yale School of Nursing’s GEPN program specializing as a Psychiatric Mental Health Nurse Practitioner.

Can you describe your current position and main responsibilities? What initially attracted you to your current role or profession?

My current role is as the UCC Psychiatry Coordinator at CFA. As the psychiatric provider on the team, I participate in rounding with UCC team (clinician, nurse and community navigator) to provide consultation on cases regarding diagnoses and any issues related to medical complexities. I’m also responsible for creating and providing clinical trainings for the UCC staff.

I was initially drawn to the profession because I have always been curious about human behavior and understanding motivation. More specifically, I was drawn to CFA and this role because it draws on all of my academic and professional experiences; from my experiences working at Alaska CARES and CPS in Wisconsin and my student experiences both at the MSW and MSN level. I remember this one child from when I was working in CPS. He was an African American male, young, 8 or 9 and so traumatized. I had to bring him to his appointment with his psychiatrist, and the psychiatrist said, “This is ADHD.” He told me he was going to write a prescription for a stimulant. So, my response was, “I know I'm a social worker here, but can you help me understand because from what I do understand of medications, that might make things worse. Can you help me understand why we're doing this?” This is also a very elderly Caucasian male. So, I just felt like the match there wasn't the best. When I asked my question, the psychiatrist seemed very dismissive and basically in a professional way told me, stay in your lane you’re just the social worker you don’t know what you're talking about. Fast-forward, the child takes the stimulant and then ends up becoming extremely aggressive. And so that was my 'aha' moment where I thought, “No, I can do this. I can go back to school and I can do this, and then I can really help these kids.” So, then I had a big life change, moved back home, and I was truly at a crossroads. It was either go back to school, to do this (Psychiatric Mental Health Nurse Practitioner) or buckle down, get my LCSW.

How do you incorporate cultural sensitivity into your practice when dealing with mental health issues in diverse populations?

I round on most patients seen at the UCC and can tell you; we sit at that table and culture is right there, and we talk about how is this family's culture impacting functioning? Is it impacting understanding of the symptoms? Is it impacting how they're showing up and sharing or not sharing with us? Trying to build that bridge with families as well. So, it's not just check, check, check, yeah this is the diagnosis. It's really all encompassing

What are some success stories or significant impacts your organization has made in the community’s mental health?

A child I saw on the outpatient side of things, who had really been struggling, came to the UCC while in crisis. Mom was well versed in the system and had access to things, and she was still running up against roadblocks getting connected to care. While she was struggling to get connected to the right care, the child was just escalating. Through his visit at the UCC we got him to the correct level of care. I think within ten days, they were connected. I had been working to get him connected for almost a year through the outpatient world. And it took ten days after his UCC assessment to get to that particular level of care (PHP for children with Autism at Hospital for Special Care).

How do you balance clinical and community-based interventions?

On a case-by-case basis we offer a psychiatric evaluation. Especially if we're thinking, does this child need to go to the emergency department (ED) or can we make a safety plan and keep them home? That's oftentimes where I get involved and do a full evaluation for the child. When I’m not doing a full evaluation, I’m meeting with the child and families and doing more of a check and asking more focused questions.

What are you most excited about in your work right now?

We know there are kids are in crisis in our community and we just to let them know we're here to help support them through that crisis in a space designed for children and families instead of having to go to the emergency department.

Can you share any advice or tips for someone aspiring to enter your field?

For new nurses, whether it's a new RN or a new NP, it would probably be the same thing. It's really hard work. It's really challenging work. So, kind of being connected to yourself and realizing when you need something, filling your own cup and don't be afraid to ask the questions.